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Dr Holliday correctly emphasizes the important distinction between the use of intravenous (IV) fluid replacement to increase a contracted extracellular fluid (ECF) volume, with which antidiuretic hormone (ADH) secretion is frequently elevated, and fluid used to replace insensible fluid losses. We would argue that clinical evaluation of the degree of ECF contraction frequently overestimates the problem, resulting in significant volumes of IV fluid being administered,1 leading to volume overexpansion and the production …
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